Gluten is getting a bad rap. Only celiac sufferers need avoid it

January 18, 2014 1:05 AM

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Celebrity testimonials tell you that gluten is causing all your health problems. More and more products are labelled gluten free as more and more people try to follow the example of these celebrities. But is it worth it?

The truth is that ever since humans developed agriculture and started harvesting wheat, about 10,000 years ago give or take a few centuries, gluten has been part of our diet. It is a protein found in wheat, rye and barley and essentially everything that derives from these basic plants, namely flour and baked goods. In the not-too-distant past, when people grew their own food, wheat in the form of bread was the staple of the human diet. If gluten were that bad for us, we would not have survived as a species.

In reality gluten is neither good nor bad for most of us. Its main function is to give elasticity to dough, allowing it to rise and maintain its shape. It also gives food a chewy texture. (Most of what we perceive as taste is really the feel, or texture, of food inside our mouth.) With the exception of people who have celiac disease, gluten should cause no harm to us.

Celiac disease is a chronic inflammatory disease of the intestines. Those who suffer from it experience bloating, chronic diarrhea and unexplained weight loss. They often fail to absorb minerals and vitamins, and consequently develop premature osteoporosis, anemia and vitamin deficiencies. Celiac disease occurs primarily in people of European ancestry who carry a particular gene that predisposes them to it. However, the gene is not enough to cause the disease. It needs an environmental trigger, and the unlikely culprit is the otherwise-benign gluten.

The Greek physician Arataeus of Cappadocia first described celiac disease back in the first century, but it was only around the time of the Second World War that the link between the disease and dietary gluten was made. After the devastation of the war, there was widespread famine across most of Europe, and bread was scarce. Individuals with celiac disease initially improved — but then worsened once Europe recovered and bread became available once again. Today the main treatment of celiac disease remains removing gluten from the patient’s diet, and the vast majority of patients respond and improve.

But most of the celebrities who have been advocating a gluten free diet probably do not have celiac disease. Unless you are a carrier of the HLA-DQ2 or DQ8 gene, or have antigliadin, endomysial or transglutaminase antibodies in your blood, it is unlikely that gluten is causing you any real problems. Avoiding gluten even if you have negative genetic and serologic tests for celiac disease makes as much sense as avoiding milk even if you’re not lactose-intolerant, or avoiding peanuts when you don’t have a peanut allergy.

What’s more, a gluten free diet is not risk-free. Most people probably don’t realize this, but flour is fortified with iron and certain B vitamins like thiamine, niacin and riboflavin. It is also fortified with folic acid. People who adopt a gluten free diet may suddenly find themselves deficient in these essential nutrients if they don’t take steps to supplement them in some form.